MEDICARE: FELICIA WILLIAMS CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	142141	GA

General Provider Information

NPI Number	:	1568590156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FELICIA WILLIAMS CNP

Provider Business Mailing Address
First Line	:	777 CLEVELAND AVE SW
Second Line	:	SUITE 204
City	:	ATLANTA
State	:	GA
Zip	:	30315-7129
Country	:	US
Telephone Number	:	404-892-5950
Fax Number	:	404-669-6954

Provider Business Practice Location Address
First Line	:	777 CLEVELAND AVE SW
Second Line	:	SUITE 204
City	:	ATLANTA
State	:	GA
Zip	:	30315-7129
Country	:	US
Telephone Number	:	404-892-5950
Fax Number	:	404-669-6954

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	07/08/2007

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